NPI | 1407989155 |
---|---|
Doing Business As | FAYETTEVILLE FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | JOHN KELLER President 770-461-3466 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 020555) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2016-04-20 |